Individual provider Active NPI

Blythe C. Pena, OD

  • Optometrist
  • Delray Beach, FL
National Provider Identifier
1013758580
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6473 Issued in FL
Practice address
900 E Atlantic Ave Ste 17
Delray Beach, FL 33483-6954
Phone
(561) 265-2020
NPI assigned
Jun 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6473 FL Primary

Addresses

Primary practice location

900 E Atlantic Ave Ste 17
Delray Beach, FL 33483-6954

Mailing address

900 E Atlantic Ave Ste 17
Delray Beach, FL 33483-6954
Phone (561) 265-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240619002675 FL Practitioner - Optometry 0244773117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kandace Haines OD IncGroup PAC ID 6507157245, 2 clinicians

Practice addresses (Care Compare)

900 E Atlantic Ave
Suite 17
Delray Beach, FL 33483-6954
Phone (561) 265-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6473FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stefani S. Martin, OD PA Optometrist CurrentSince Jun 9, 2024 Accepting new patients
Kandace Haines OD Inc Optometrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

900 E Atlantic Ave
Ste 17
Delray Beach, FL 33483
Phone (561) 265-2020

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1013758580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E ATLANTIC AVE STE 17",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334836954",
            "telephone_number": "561-265-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E ATLANTIC AVE STE 17",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334836954",
            "telephone_number": "561-265-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "BLYTHE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "6473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.